STATE OF OREGON
Board of Medical Imaging
PHONE 971.673.0215
www.oregon.gov/obmi
Overview of Guidelines for Instructors of
Courses in Preparation for the Limited Scope Examination in
Diagnostic Radiologic Technology
July, 2013
1
Table of Contents
INTRODUCTION .................................................................................................3
COURSE CONTENT ...........................................................................................4
PROGRAM REQUIREMENTS ............................................................................6
DIRECTOR ...............................................................................................6
INSTRUCTORS ........................................................................................7
FACILITIES...............................................................................................8
STUDENT POSITIONING PRACTICE .....................................................8
COURSE OBJECTIVES ......................................................................................9
RADIOGRAPHIC PROCEDURES and POSITIONING ............................9
VIEW SELECTION .................................................................................10
ANATOMY ..............................................................................................10
TECHNIQUE ...........................................................................................11
EQUIPMENT OPERATION and X-RAY PRODUCTION ........................12
RADIATION PROTECTION (CORE) ......................................................13
EXAMINATION ..................................................................................................14
PROCESS TO OBTAIN A PERMANENT LIMITED PERMIT..........................14
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INTRODUCTION
The purpose of the ..Limited X-ray Machine Operator (LXMO) course is to give
students the opportunity to learn and be able to demonstrate basic principles of
Radiation Protection, Quality Control, Equipment Operation, Image Production
and Evaluation, Patient Care, and Radiographic Procedures. The course must
be directed toward individuals working in X-ray who are not and cannot be
ARRT certified. The radiographic principles taught in this course should be
designed for the Limited X-Ray Machine Operator who has a limited science and
medical background. The course must cover basic radiographic principles;
radiographic positioning; film and processing; formulation of radiographic
techniques; patient care; and radiation protection. A certificate must be issued to
the student upon successful completion of the course.
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I.
COURSE CONTENT
Enclosed is a topical outline containing minimum guidelines; it does not
necessarily show the sequence in which the material should be presented. As an
instructor, you would submit to the board for approval your own course outline
that includes the subjects listed on the following pages.
The course consists of three parts:
1.
Core Module covering Radiation Protection Equipment Operation,
Quality Control, Image Production and Evaluation, and Patient
Care;
2.
Radiographic Procedure Module(s) covering the Positioning and
Techniques for each specific body area;
3.
Practical Experience
The Core portion of the course must contain a minimum of 52 hours of
instruction approved by the Board and reflect the current Core Module of the
“Content Specifications for the Examination for the Limited Scope of
Practice in Radiography” published by the American Registry of Radiologic
Technology. The curriculum shall include, but is not limited to:
Biological effects of radiation
Interaction of radiation with matter
Low-dose technique and minimizing patient exposure
Personnel Protection
Radiation exposure, monitoring, and radiation units
Applicable Federal and State radiation regulations
Radiation physics
Principle of the radiographic equipment
Darkroom and film processing and quality assurance
Digital and computer-generated radiographic imaging
Film and image critique
Developing and using technique charts
Patient Care
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The Radiographic Procedures portion of the course must meet the minimum
hourly requirements listed below, and reflect the current Radiographic Procedure
Module for of the “Content Specifications for the Examination for the Limited
Scope of Practice in Radiography” published by the American Registry of
Radiologic Technology. The curriculum shall include, but is not limited to:
Skull/Sinus
Spine
Chest
Extremities
Podiatric
18 hours
30 hours
12 hours
60 hours
10 hours
The Practical Experience component of the student’s training must consist of
experience with live patients during which images are acquired and the finished
radiographic images are made available to the Practical Experience Evaluator for
critique. In order to practice on live patients, a student must first complete the
coursework, pass the state ARRT examination, and obtain a temporary permit
from the OBMI. During the period of time a student or graduate holds a temporary
permit, schools must provide a plan to regularly evaluate the temporary permit
holder’s clinical competency.
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II.
PROGRAM REQUIREMENTS
Prior to the first class meeting, Board approval to offer the course is required. In
order to receive approval, please meet these requirements and provide the
Board with the following information:
1.
The portions of the limited permit course you plan to teach.
2.
The number of classroom hours for each portion.
3.
The location of the course.
4.
The topics that will be covered in each portion of the course.
If you don’t plan to follow the enclosed outlines for the didactic portions of the
course, please provide the Board with a detailed outline of the topics you plan to
cover.
Additionally, please provide detailed information about how you plan for the
practical experience requirement to be fulfilled, after the coursework is
completed, including any types of examinations your students will be required to
perform on live patients.
If you plan to offer limited permit classes on a continual basis, please request
approval annually by submitting to the Board an outline of the program and the
names of all Board approved instructors. The deadline for your submittal is July
1; the Board will remind you of this obligation.
A.
DIRECTOR
1.
Currently licensed, in good standing in
Diagnostic Radiologic Technology and
2.
Currently ARRT certified (No CE Probation) in Diagnostic
Radiologic Technology and
3.
10,000 hours of documented diagnostic experience in Radiologic
Technology.
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B.
INSTRUCTORS
1.
Formal teaching method of new approved instructors will be
evaluated by the Board on a case-by-case basis. This assessment
will include the use of:
a.
Instructional aids
b.
Demonstration methodology
c.
Handouts/study materials
d.
Curriculum guide
e.
Personal interview with a site survey member
2.
Qualifications of Radiation Protection Instructors
a.
Currently ARRT certified (No CE Probation) in Diagnostic
Radiologic Technology; and
b.
Currently licensed, in good standing for at least two years
in Diagnostic Radiologic Technology; and
c.
4,000 hours of documented diagnostic experience in
Radiologic Technology; or
d.
Medical Radiation Physicist; or
e.
Doctor of Medicine, Osteopathy, Chiropractic or Podiatric
Medicine, board qualified in Diagnostic Radiology.
3.
Qualification of Equipment Operation, Quality Control, Image
Production, Image Evaluation, and Patient Care Instructors
a.
Currently ARRT certified (No CE Probation) in Diagnostic
Radiologic Technology; and
b.
Currently licensed, in good standing for at least two years
in Diagnostic Radiologic Technology; and
c.
4,000 hours of documented diagnostic experience in
Radiologic Technology; or
d.
Chiropractic physician.
4.
Qualifications of Radiographic Procedure Modules Instructors
a. Currently ARRT certified (No CE Probation) in Diagnostic
Radiologic Technology; and
b. Currently licensed, in good standing for at least t w o y e a r s
in Diagnostic Radiologic Technology; and
c. 4,000 hours of documented diagnostic experience in Radiologic
Technology; or
d. As an exception to the above qualifications, lectures
associated with positioning classes may be given by a
physician who is board qualified/certified in Diagnostic Radiology
(based on their scope of practice).
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C.
D.
FACILITIES
1.
Minimum of one energized X-ray machine available for student use
under the direct supervision of the Board approved training
program instructor, for Radiation Protection, Image Production and
Evaluation labs. X-ray simulator units can be used for anatomic
positioning demonstrations.
2.
Operational darkroom available for student use (manual or
automatic processing), or digital imaging equipment if analog is not
used.
3.
Technique charts designed for the type of equipment being used,
specifically correlated to each control panel utilized by
students.
STUDENT POSITIONING PRACTICE
During positioning practice and labs, after demonstration and explanation by the
instructor, the student will:
1
Demonstrate on a peer or other instructor the proper patient
positioning, tube alignment and angulations, and film or image
receptor position for all major and most secondary views that
pertain to the anatomical area being taught as outlined in the
“Content Specifications for the Examination for the Limited Scope
of Practice in Radiography” published by the ARRT.
2.
Prior to being allowed to perform positioning on live patients, the
student will demonstrate proficiency in performing the appropriate
positions in a simulated setting. Also, the student will need to obtain
a temporary permit from the OBMI before positioning live patients.
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III.
COURSE OBJECTIVES
NOTE: The following course objectives should be used in correlation with the
“Content Specifications for the Examination for the Limited Scope of
Practice in Radiography” published by the American Registry of
Radiologic Technologists.
A.
RADIOGRAPHIC PROCEDURES and POSITIONING
1.
Name the position/projection when given a description of the
position/projection.
2.
When given a specific projection for a specific anatomic part, select
the aspect of the part that is in contact with the film.
3.
Name and select the appropriate landmarks when given a specific
projection for a specific anatomic structure.
4.
Identify the proper alignment of the body plane to the film for a
specific projection for a specific anatomic structure.
5.
Identify the orientation of the central ray relative to the specific body
plane, the film and the specific anatomic structure when given a
specific projection for a specific anatomic structure.
6.
Identify t h e
radiographic
appearance
of
a
specific
anatomic structure when that structure is properly positioned.
7.
Give the reason for a general requirement of correct positioning for
a specific projection. Describe the specific positioning method
required and/or a description of the radiographic evidence verifying
the correct positioning.
8.
Identify common positioning errors for a specific projection.
9.
Describe an appropriate modification of a usual positioning
technique for a specific examination when pathologic conditions
require modification of the usual technique.
10.
Identify the correct orientation of a reference line to the film and/or
the orientation of the central ray to a reference line of a specific
projection.
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B.
C.
VIEW SELECTION
1.
Select the anatomic structure(s) best demonstrated or not well
demonstrated and/or pathology that must be demonstrated when
given the name of a specific projection or examination.
2.
Select the appropriate projections or positions and/or the most
common projections when given an anatomic structure or an area
to be radiographed.
3.
When given the name or description of a specific pathologic
condition, select the appropriate projection(s)/position(s) that will
demonstrate that specific pathologic condition.
4.
When given an anatomic diagram designating a specific structure,
select the appropriate projection/position to demonstrate the
designated structure.
5.
When given a specific description of a specific fracture, select the
name of the fracture or fracture type.
ANATOMY
1.
When given an anatomic term, select its synonym and/or its
definition.
2.
When given the name of an anatomic structure, identify the
following:
a.
a description of the structure
b.
a description of its location
c.
the name(s) of one or more components
d.
a name which does not designate a component
e.
the number of its components
f.
the name of the surrounding structure(s)
g.
a description of the surrounding structure(s)
3.
When given the description and/or location of an anatomic structure
or group of structures, select:
a.
the names of additional parts
b.
the name of the structure
c.
the location of the structure
d.
the location of the part relative to the structure
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D.
4.
When given the name of a bone, identify the following:
a.
the name(s) of (a) bone(s) with which it articulates
b.
the number of bones with which it articulates
5.
When given an anatomic diagram, identify the following:
a.
the name of the structure depicted
b.
the position or aspect of the structure depicted
6.
When given the name of a specific anatomical structure, state the
basic physiology of that structure.
TECHNIQUE
1.
Explain the effect of kVp, mAs and SID on the formation of the
image.
2.
Explain the
will affect it
a.
b.
c.
d.
source of scatter radiation and how the following factors
part size
kVp selection
collimation
grid use
3.
Identify the factors that influence the selection of a grid for specific
radiographic procedures.
4.
Explain the image receptor used for an exam
a.
film/screen
1. speed
2. processing
b.
digital
1. Computed radiography (CR)
2. DR or flat panel receptors
3. Exposure indicator numbers
5.
Select the appropriate corrective measure when given a specific
radiographic examination and description of a problem or error.
6.
Select the purpose, the examination or projection for which a
specific respiratory phase or method is used and the anatomy best
demonstrated when given a specific respiratory phase or method.
7.
Select proper machine settings for given radiographic positions
taking into consideration all technical variables such as patient size,
age, pathologies, casts, and accessory devices.
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E.
EQUIPMENT OPERATION and X-Ray Production
1.
Identify the basic components of an x-ray tube, state the
composition, function of each and its purpose in the production of xrays. Include:
a.
filament - electron source, focal
spot size
b.
anode - target
c.
characteristic radiation
d.
Bremsstrahlung
2.
Operator Console
a. kVp selection
b. mA selection
c. time selection
d. mAs
e. AEC selection
3.
Identify the basic components of the x-ray generator, state the
function of each and its purpose in the production of x-rays.
Include:
a.
basic electrical circuits
b.
transformers
c.
rectifiers
d.
phase, pulse, and frequency
4.
Identify and operate the basic components of the radiographic unit,
state the function of each and its purpose in the overall operation
of the unit. Include:
a.
operator’s console and all controls
b.
exam table, upright bucky and all controls
c.
tube and beam restriction devices and all controls
5.
Explain the basic characteristics of the x-ray beam and those
exposure factors that affect each. Include:
a.
wave length and frequency
b.
primary, remnant, and scatter
c.
quantity vs. quality
6.
Explain the basic concepts of photon interaction with matter.
Include:
a.
tissue attenuation
a.
atomic number,
b.
size, thickness
c.
density
b.
Compton effect (scatter)
c.
Photoelectric affect (absorption)
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F.
RADIATION PROTECTION
1.
Explain the biological effects of radiation on humans, giving
examples of those effects. Include:
a.
the relative radiosensitivity of, and reactions to radiation of
each body system
b.
Somatic Effects
c.
Systemic Effects
d.
Genetic Effects
e.
Fetal risks
2.
Explain methods of reducing patient exposure during radiographic
examinations. Include:
a.
relationship of exposure factors to dose (kVp, mAs, SID,
OID)
b.
collimation and beam restriction methods
c.
shielding
d.
filtration, requirements, and effects
e.
film, screen, and other image receptors sensitivity
3.
Explain methods of protecting personnel and other non-patients
from expose during radiographic examinations.
a.
Identify sources of exposure
b.
Identify methods of protection to include time, distance, and
shielding
c.
Identify types of protective devices and their required lead
equivalents
4.
Define the units of measurement for radiation exposure.
5.
Identify the recommended exposures for the following:
a.
public
b.
occupational workers
c.
embryo/fetus
.
6.
7.
Identify dosimeters used for occupational exposure and explain how
they are used.
Explain and give examples for applying ALARA.
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IV.
LIMITED SCOPE EXAMINATION IN DIAGNOSTIC
RADIOLOGIC TECHNOLOGY
After successful completion of the Core Module and the Radiographic Procedure
Module(s), students will be required to take the Limited Scope of Practice in
Radiography Examination administered through the American Registry of Radiologic
Technologists (ARRT) effective January 1, 2007.
A minimum score of 70% is required, in Core Module as well as any radiographic
procedure modules, to be considered a passing score. Any change to the minimum score
would require an amendment to The OBMI’s administrative rules.
V.
PROCESS TO OBTAIN A PERMANENT LIMITED PERMIT
To qualify for a permanent limited permit, unless you are a bone densitometry student, you
must complete all of the following actions:
1. Complete a Board-approved course in CORE and the anatomical area(s) you wish to
practice in. The school will provide a signed and dated course completion certificate.
The following steps 2-6 must be completed within one year of the date the course
completion certificate was signed:
2. Pass the state examination in CORE and at least one anatomical category.
STEPS 2-6
(You may re-take the different sections of the examination for which you
MUST
completed the coursework up to three times.)
ALL
3. Submit an application to the Board for a temporary limited permit.
BE
4. Obtain a temporary permit covering the anatomical areas you passed on your
FINISHED
exam; this is required to practice on live patients.
WITHIN
5. Complete the practical experience requirements relevant to any anatomical
ONE
areas on your temporary permit.
YEAR
6. Submit your application to the Board for a permanent limited permit in the
FROM
anatomical areas for which you received a temporary permit and completed
COURSE
your practical experience requirements.
COMPLETION
AFTER ONE YEAR, STUDENT MUST START AGAIN
For any anatomical areas that are not on your permanent permit after one year from the date
your course completion certificate was signed, you will be required to re-enroll in an
approved school and complete the coursework and finish the above-listed requirements
within one year from your new course completion date. If you previously passed the CORE
examination but then failed to obtain a permanent permit within one year from your
previous course completion date, you will need to re-take CORE in addition to the
anatomical areas for which you wish to practice. If you already passed CORE and have
already obtained a limited permit, and are seeking to add anatomic areas to your existing
permit, you only need to follow the 6-step process above for anatomic areas; you will not be
required to re-take CORE.
Additional program questions should be directed to the Board office:
971.673.0215.
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